Effect of Combined Chelation Therapy with Deferiprone and Deferoxamine on Left Ventricular Diastolic Function in Adult β-Thalassemia Major Patients

Abstract

β-Thalassemia major (β-TM), patients, asymptomatic and with preserved left ventricular ejection fraction (LVEF) were studied echocardiographically. Group A (26 patients), on deferiprone (L1) and deferoxamine (DFO) combination therapy (L1: 80 ± 27 mg/kg/day, DFO: 160 ± 87 mg/kg/week) and group B (35 patients) on DFO monotherapy (240 ± 40 mg/kg/week) for the last 2 years were compared. Another group, C (14 patients), switched to L1 (74 ± 15 mg/kg/day) plus DFO (158 ± 48 mg/kg/week) for 20–30 months, was prospectively studied for 2 years.

In group A, MRI T2* values were increased and improved in group C during follow-up. The LVEF was better in group A than in group B, while such an improvement was also detected in the group C follow-up study. The Tissue Doppler study E′ velocity and E/E′ ratio was not different. Similarly, in the group C follow-up no significant change in E/E′ ratio was detected. It seems that although LVEF significantly improves with combined therapy, diastolic function indexes do not show a similar change.

Keywords:

• Thalassemia
• Combined chelation therapy
• Cardiac function
• Diastolic function